1. Field of the Invention
The present invention relates to surgical retractor apparatus. More particularly, the present invention relates to pressure relief pads used to prevent nerve damage and to improve circulation during surgery. Additionally, the present invention relates to pressure relief pads that can be used with circumferential retractors during surgery.
2. Description of Related Art
Surgical “retraction” is the drawing back of body tissue. When the operation involves making an incision, the incision itself often must be retracted. During surgery, internal organs, bones and tissues are intermittently retracted through the opening created in the retracted incision.
In certain surgeries, an assistant's fingers are used as retractor paddles. However, greater technical ease is available through the use of various mechanical retractor systems. Mechanical retractor systems can be divided into two major groups: externally mounted “fixed” to the operating table and self-retaining retractors.
The mechanical systems attached to the operating table present the same type of physical obstruction to the surgeon's movement as presented by the assistant's body, arms and hands since the externally fixed retractor systems of a vertical column, supporting arm(s) or ring and retractor paddles attached thereto. The retractor paddles, support arms or ring and vertical column in these apparatus are adjustable in multiple planes and axes of motion; however, these retractor paddles are not all independently adjustable in the vertical plane. Movement of a support arm or ring of these apparatus necessitates movement of all retractor paddles attached thereto.
Ideally, mechanical retractors, both externally mounted and self retaining, need to provide for internal organ and tissue retraction, be quickly and easily assembled, positioned and repositioned in all planes and axes of motion, present as little obstruction to the surgeon's movement as possible, protect the sterile field, diminish the risk of tissue trauma and yet be stable enough to function adequately while reducing the need for assistance.
Self-retaining retractors that have attempted to provide for internal organ and tissue retraction through the open incision have failed to permit quick, independent, easy and safe adjustment of internal organ and tissue retractor paddles in all planes and axes of motion, and in effect the prior art is either ineffectual or unsafe, or both since these paddles are not easily adjustable in the vertical plane and such internal organ and tissue retractor paddles must traverse over (or through) internal tissue before reaching the desired location along the retractor handle and/or frame. The retractor paddle depth is not highly variable and the retractor paddles' location on the retractor frame is limited.
In the past, various patents have issued relating to such retractors. For example, U.S. Pat. No. 5,520,610, issued on May 28, 1996 to Giglio, describes a self-retaining retractor. This retractor includes flexible, resilient retractor paddles which can be placed into the incision. A rigid frame is provided which includes two interlocking halves laid longitudinally over the incision. The incision retractor paddles are manually clipped to each frame half, and then the frame halves are opened to the desired extent. The incision retractor paddles and the frame provide the apparatus with stability for retraction of internal organs and tissues through the open incision by the addition of mounting jigs containing adjustment posts onto mounting means which radiate outwardly from the frame.
U.S. Pat. No. 5,931,777, issued on Aug. 3, 1999 to G. A. Sava, teaches a tissue retractor with particular use in spinal surgery. This tissue retractor includes a pair of pivotally linked arms, each with a blade mounted thereto by a ball-and-socket joint so as to allow free movement of the blades relative of the arms. The blades have an anchoring end to anchor to the bone. The retractor is operable by placing the blades in a wound opening, securing the anchoring ends to a portion of the bone in a position apart from each other, and operating the retractor to cause the blades to separate and to retract tissues surrounding the wound opening by outward pivoting of the blades relative to the position of the anchoring ends.
U.S. Pat. No. 6,074,343, issued on Jun. 13, 2000 to Nathanson et al., describes a surgical tissue retractor comprised of a plurality of retractor blades that can be operated simultaneously. Right and left retractor blades are mounted on an actuator mechanism that spreads or expands the blades as a rotatable primary actuator knob is rotated. A third retractable arm is mounted for simultaneous operation with the right and left retractor blade or independent operation through a secondary rotatable actuator knob that extends or retracts a threaded shaft attached to the center retractor blade.
U.S. Pat. No. 6,090,043, issued on Jul. 18, 2000 to Austin et al., describes a tissue retractor including a hook, a handle and an elastomeric band. The hook has a tissue-engaging portion and is retained by the handle such that the,tissue engaging portion extends from a first end of the handle. The handle end of the band is retained by a second end of the handle. The back has a longitudinal body and at least one hub disposed about the body.
One of the present inventors developed a circumferential retractor apparatus which is presently the subject of U.S. patent application Ser. No. 09/916,819, filed on Jul. 30, 2001. This application describes a circumferential retractor apparatus having a first retractor paddle having a grasping surface and a body portion supporting the grasping surface, a second retractor paddle having a grasping surface and a body portion supporting the grasping surface, and an elastic member having one end received by the first retractor paddle and an opposite end received by the second retractor paddle. Each of the paddles has a hole formed therein of a size suitable for allowing the elastic member to pass therethrough. A slot is formed in the body portion so as to open to the hole. The slot is of a tapered configuration so as to have a wide end opening to the hole and a narrow end away from the hole. The grasping surface includes a plurality of fingers extending outwardly of the body portion. Each of the plurality of fingers are arranged in parallel spaced relationship to each other. The elastic member is a length of surgical tubing. During surgery, the grasping surface of the first retractor paddle engages one side of the incision while the grasping surface of the second retractor paddle engages the opposite side of the incision. The tension in the surgical tubing will maintain the incision in an open condition. The surgical tubing will extend around the body member in a tensioned condition.
Since the surgical tubing has a relatively small diameter, the pressure applied by the surface of the surgical tubing to the body member has relatively great force in pounds per square inch. As such, a need has developed so as to remedy the problem of pressure applied against the body member and to reduce the possibility of nerve damage or impaired circulation during surgery.
It is an object of the present invention to provide a pressure relief device which can be used with elastic members associated with circumferential retractors.
It is another object of the present invention to provide a pressure relief device which can eliminate or significantly reduce any pressures applied by surgical tubing to the body member subjected to surgery.
It is a further object of the present invention to provide a pressure relief device which is adaptable to a wide variety of types of surgery and adaptable to different shapes of body members.
It is still a further object of the present invention to provide a pressure relief device which is easy to manufacture, relatively inexpensive and easy to use.
These and other objects and advantages of the present invention will become apparent from a reading of the attached specification and appended claims.